Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Observational Study
Noninvasive pulse pressure variation and stroke volume variation to predict fluid responsiveness at multiple thresholds: a prospective observational study.
Pulse pressure variation (PPV) and stroke volume variation (SVV) are dynamic preload variables that can be measured noninvasively to assess fluid responsiveness (FR) in anesthetized patients with mechanical ventilation. Few studies have examined the effectiveness of predicting FR according to the definition of FR, and assessment of inconclusive values of PPV and SVV around the cut-off value (the "grey zone") might improve individual FR prediction. We explored the ability of noninvasive volume clamp derived measurements of PPV and SVV to predict FR using the grey zone approach, and we assessed the influence of multiple thresholds on the predictive ability of the numerical definition of FR. ⋯ Noninvasive PPV and SVV measurements allow an acceptable FR prediction, although the reliability of both variables is dependent on the intended increase in SVI, which improves substantially with concomitant smaller grey zones at higher ↑SVI thresholds.
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Pulmonary aspiration of gastric contents is a major cause of anesthesia morbidity and mortality. Point-of-care gastric ultrasound provides information regarding the type and volume of gastric content. The hypothesis of this prospective cohort study was that the addition of point-of-care gastric ultrasound to standard patient assessment results in changes in anesthetic management in at least 30% of elective surgical patients who do not follow fasting instructions. ⋯ This prospective case series suggests that a standardized point-of care gastric ultrasound examination informs anesthesiologists' perceived level of aspiration risk and leads to changes in anesthetic management in a significant proportion of elective patients who did not follow fasting instructions.
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Erratum to: Can J Anesth/J Can Anesth 2015 DOI 10.1007/s12630-015-0441-9. In the article entitled: "Real-time ultrasound-guided epidural catheter insertion in obese parturients" published in the November 2015 issue, Can J Anesth 2015; DOI: 10.1007/s12630-015-0441-9, the name of the third author is incorrect and should read: Marc Edouard Gentili. The publisher apologizes most sincerely for this error.